Improving psychologic adjustment to chronic illness in cardiac patients. The role of depression and anxiety
Department of Pediatrics; Department of Psychiatry
Adaptation, Psychological; Aged; Angina, Unstable; Anxiety; Chronic Disease; Counseling; Depression; Female; Humans; Male; Middle Aged; Myocardial Infarction; Myocardial Ischemia; Prospective Studies; Recovery of Function; Telephone
Life Sciences | Medicine and Health Sciences
BACKGROUND: Poor mood adjustment to chronic medical illness is often accompanied by decrements in function. OBJECTIVE: To evaluate the effectiveness of a telephone-based intervention for psychologic distress and functional impairment in cardiac illness. DESIGN: Randomized, controlled trial. METHODS: We recruited survivors of acute coronary syndromes using the Hospital and Anxiety Depression Scale (HADS) with scores indicative of mood disturbances at 1-month postdischarge. Recruited patients were randomized to experimental or control status. Intervention patients received 6 30-minute telephone counseling sessions to identify and address illness-related fears and concerns. Control patients received usual care. Patients' responses to the HADS and the Workplace Social Adjustment Scale (WSAS) were collected at baseline, 2, 3, and 6 months using interactive voice recognition technology. At baseline, the PRIME-MD was used to establish diagnosis of depression. We used mixed effects regression to study changes in outcomes. RESULTS: We enrolled 100 patients. Mean age was 60; 67% of the patients were male. Findings confirmed that the intervention group had a 27% improvement in depression symptoms (P=.05), 27% in anxiety (P=.02), and a 38% improvement in home limitations (P=.04) compared with controls. Symptom improvement tracked those for WSAS measures of home function (P=.04) but not workplace function. CONCLUSIONS: The intervention had a moderate effect on patient's emotional and functional outcomes that were observed during a critical period in patients' lives. Patient convenience, ease of delivery, and the effectiveness of the intervention suggest that the counseling can help patients adjust to chronic illness.
DOI of Published Version
J Gen Intern Med. 2005 Dec;20(12):1084-90. Link to article on publisher's site
Journal of general internal medicine : official journal of the Society for Research and Education in Primary Care Internal Medicine
McLaughlin, Thomas J.; Aupont, Onesky; Bambauer, Kara Z.; Stone, Peter H.; Mullan, Mariquita G.; Colagiovanni, Jane; Polishuk, Elaine; Johnstone, Michael T.; and Locke, Steven E., "Improving psychologic adjustment to chronic illness in cardiac patients. The role of depression and anxiety" (2006). Open Access Articles. 1057.